YOUR PRESENT EMAIL:

Your First Name:

Your Last Name:

5. Highest level of formal education

6. Approximately how many years have you been with your current or most recent employer?

7. What is the most important reason you were job searching?

8. What are the top 3 factors you consider the most important in selecting a new job? (Select 3)

10. How many times per month on average did you attend Five OClock Club meetings?Clock

11. Approximately how many sessions did you attend in total?

12. Do you currently attend meetings?

13. Reason for not attending meetings:

15. Must you relocate for your new job?

15b. If so, how many miles is your move?

16. Indicate the job/function, then industry of your last job. (Use Code Charts below)

JOB/FUNCTION CODES

1 General Management

2 Project Management

3 Planning/Other Corporate Services

4 Marketing/Sales

5 Manufacturing/Operations

6 Finance

7 Accounting/Control

8 Engineering

9 Information Services

10 Human Resources

11 Public Relations

12 Research and Development

13 Consulting

14 Teaching

15 Law-Professional Advising

16 Medical-Professional Advising

17 Religion-Professional Advising

18 Investment-Professional Advising

19 Other-Professional Advising

20 Other

INDUSTRY CODES

Manufacturing

20 Aerospace, automotive and

 transportation equipment

21 Chemicals/pharmaceuticals

22 Consumer products

23 Energy and extractive

24 Food and beverages

25 High technology/electronics

26 Agribusiness

27 Paper and forest products

28 Textiles and apparel

29 Machinery

30 Other manufacturing

31 Highly diversified (mfg. only)

Non Manufacturing

50 Accounting/auditing

51 Consulting

52 Commercial banking

53 Insurance

54 Investment banking

55 Other diversified financial

56 Retail trade

57 Wholesale trade

58 Utilities

59 Printing/publishing

60 Other communications

61 Entertainment/leisure

62 Hotel/motel or restaurant

63 Transportation

64 Advertising

65 Real estate and construction

66 Trading companies

67 Computer-related services

68 Law

69 Education

70 Government

71 Other nonprofit

72 Highly diversified services

73 Other miscellaneous services

Manufacturing and

Non Manufacturing

90 Highly diversified

17. Now indicate the job/function, then industry of your new job.

18. What is the size of the last organization for which you worked?

19. What is the size of the new organization?

20. About how many months did it take from the time you seriously started looking until you found a new job?

21. How many months after you joined the Five OClock Club was it until you found a job?

22. How much time did you devote to your job search per average week in hours?

23. How do you rate your new situation?

Name of Employer:

New Job Title:

Address:

City:

State:

Zip:

New Work Phone:

New Work Email:

Address:

City:

State:

Zip:

New Home Phone:

 Home Email:

26. Would you be willing to be listed as a member of our networking database (and also benefit from it)?

What career/occupational areas do you feel comfortable speaking to current members about?

What method may members use to contact you? (List work phone, work email, home phone, and/or home email.)

27. Additional Comments:

28. If you are not currently attending, do you intend to resume your attendance at the Club in the future?

29. You will resume Club attendance in about how many months?

Name of Employer:

Address:

City:

State:

Zip:

Work Email:

31. Indicate the job/function, then industry of your present or most recent job. (Use Code Charts above)

Address:

City:

State:

Zip:

New Home Phone:

 Home Email:

33. Would you be willing to be listed as a member of our networking database (and also benefit from it)?

What career/occupational areas do you feel comfortable speaking to current members about?

What method may members use to contact you? (List work phone, work email, home phone, and/or home email.)

34. Additional Comments: